It Came Across the Plains: the 1918 Influenza Pandemic in ...
Planning for the next Pandemic - Immunisation Advisory Centre · pandemic on NZ Plan for it Manage...
Transcript of Planning for the next Pandemic - Immunisation Advisory Centre · pandemic on NZ Plan for it Manage...
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Planning for the next Pandemic
IMAC Immunisation Workshop
5 September 2019
Angie Perry – Senior Advisor
Diana Murfitt – Senior Advisor
Click to edit Master title styleOverview
• Why do we need to be prepared?
• Planning to date
• Brief overview of our most recent pandemic
• Pandemic scenario
• Planning a Mass Immunisation Programme
• Next steps
Click to edit Master title stylePrevious influenza pandemics
1918 1957 1968 2009
A(H1N1) A(H2N2) A(H3N2)
“Hong Kong Flu”
20 - 40 m deaths 1 - 4 m deaths 1 - 4 m deaths
“Spanish Flu” “Asian Flu”
A(H1N1)
“Swine Flu”
0.3 m deaths
Click to edit Master title styleWhy do we need to be prepared?
• May occur at anytime with
little warning
• Unpredictable in severity
and who will be most affected
• Not “if” but “when”
• Impacts on the National
Security System
Click to edit Master title styleNational Health Emergency Plans
National Health
Emergency Plan: H5N1
Pre-Pandemic Vaccine
Usage Policy
National Health
Emergency Plan:
National Reserves
Click to edit Master title styleNew Zealand Influenza Pandemic Plan (NZIPAP)
Objective: to minimise deaths, serious illness & disruption to communities & the economy
• outlines all-of-government approach
• overarching framework for actions
• overview of activities to ensure NZ is prepared for and responds to a pandemic
• focuses on pandemic influenza but could be applied to other respiratory type pandemics
• Scalable
Click to edit Master title stylePandemic Response Strategy
HumanTo minimise the impact of the
disease, and to mitigate its effects on the people of NZ without increasing health inequalities
SocietalTo enable society to continue to function as normally as possible
during and after a pandemic
EconomicTo minimise and mitigate the economic consequences of a
pandemic on NZ
Plan for itManage it – post peak
Keep it
OutStamp it
outManage it
Recover from it
Plan and prepare
to reduce the
health, social and
economic impact
of a pandemic on
New Zealand
Prevent, or delay to
the greatest extent
possible, the arrival
of the pandemic
into NZ
Control and/or
eliminate any
clusters found in
New Zealand
Reduce the impact
of pandemic
influenza on New
Zealand’s
population
Expedite recovery,
and prepare for a
re-escalation of
response
Expedite the recovery of
population health,
communities and society
where affected by the
pandemic, pandemic
management measures,
or disruption to normal
services
Click to edit Master title styleNational Reserve Supplies
National Reserve Supplies
Stored by DHB Stored by Ministry
Volumes held by Ministry
P2 and General Purpose masks
√ 17 million units compiled of P2 & general purpose masks
Personal protective equipment
√
Clinical equipment √
Antivirals (Tamiflu & Relenza)
√ √ 1.3M courses
Pandemic antibiotics √
H5N1 pre-pandemic vaccine √ 150,000 courses (300,000 doses)
Vaccination supplies √ 10.2M syringes & 40,000 sharps bins
Body bags √ 24,700
Click to edit Master title style2009 A(H1N1) Influenza Pandemic
• WHO declared Pandemic → by 30 April A(H1N1) was notifiable in NZ
• A(H1N1) was highly infectious → both symptomatic and asymptomatic infections
• 18% of NZers (800,000) infected during the first wave
• 1 in 3 school aged children & 1 in 4 preschoolers were infected
• Older people had pre-existing immunity which provided protection
• From 1 April to 31 December 2009
- 3211 confirmed cases
- 1122 hospitalisations
- 35 deaths
• Highest notification rates - <1s
• High notification & hospitalisation rates – Maori and Pacific peoples
Source: ESR (2010) Seroprevalence of the 2009 influenza A (H1N1) pandemic in New Zealand. Available at www.health.govt.nz/publication/seroprevalence-2009-influenza-h1n1-pandemic-new-zealand
Click to edit Master title styleEarly Protection Immunisation Programme
2010 Influenza Immunisation Programme
- Part 1: Early protection - 1 February
- Part 2: Annual Influenza Immunisation Programme - 8 March
Early Protection Immunisation Programme – H1N1 monovalent vaccine
- For front line health care workers & those at high risk e.g. pregnant
women, morbidly obese
- Two doses required at least three weeks apart
- DHB run clinics
- 10 dose vials
- Vaccine must be used within 3 hours
Early Protection
Immunisation
ProgrammeInformation pack
Click to edit Master title styleImagine this pandemic scenario…
• 40% of NZers (>1.9 million) have been sick in last 8 weeks
• Peaking at weeks 3-5: 1.5 million sick, convalescing or just recovered
• 38,000 deaths over 8 weeks peaking at 23,500 in week 4 (NZ weekly death rate around 600)
Click to edit Master title stylePandemic immunisation scenario
• Pandemic vaccine purchased – arriving in 26 weeks
• 100% population coverage
• 2 dose course- given 3 weeks apart
• Multi-dose vial
• Vaccine must be used within 3 hours
• MVP implementation planning
underway by Ministry & DHBs
Click to edit Master title styleQuestions
• What are your learnings from past outbreak immunisation responses?
• What additional resources do you think you would need to effectively run a MVP in your area?
• List your top three considerations for a MVP
• What guidance & support would you need to enable you to successfully achieve a MVP in your region (from your PHO/DHB and at the National level)?
Click to edit Master title styleNext steps
• Update NZIPAP
• Ongoing review of the NRS supply policy and stock
• Review suite of supporting guidance and tools that support the activities of the NZIPAP e.g. NZIP